Many suffering from mental illness face waiting lists for service due to a shortage of psychiatrists and funding, advocates say

âThe waiting time to get to an outpatient clinic can be measured in months for some people,'' said Dan Eisenhauer.

Community mental health resources in the midstate are ready to help, particularly in times of crisis. But once clients reach the system’s front door, they often face waiting lists, services curtailed by state funding cuts and a shortage of psychiatrists.

That’s on top of the continuing cultural stigma patients often feel for even seeking treatment in the first place.

“There is no bigger area of immediate need than the accessibility of mental health treatment in this county,” said Dauphin County Commissioner George Hartwick, who oversees the county's Human Services Department and chairs the County Commissioners Association of Pennsylvania's Human Services Policy Committee.

“Individuals with serious mental illness deserve the same access and treatment to care as individuals with physical health conditions,’’ Hartwick said. “They have the ability, under appropriate treatment, to live the same quality of life as someone treated for any other illness.”

Last year, counties statewide sustained a 10 percent cut in base funds they receive and they continue to feel its effects.

“We had no choice with the funding cuts. We moved people to a lower level of care and support and we are still adjusting to those cases,” said Dan Eisenhauer, director of Dauphin County’s Mental Health/Intellectual Disabilities program. “The resources don’t exist to serve adequately.”

Consequently, he expects to see individuals return to the system in a crisis situation, requiring more intensive, expensive intervention.

“We already have seen an uptick in [people] trying to access the crisis intervention side as the main front door,” said Hartwick, who noted the issue is “very personal to me,” as one of his best friends took his own life.

County mental health systems are designed to help people with a mental health need and with limited financial or insurance resources gain access to treatment and supports. In addition to the crisis intervention side, counties process individuals seeking a publicly funded mental health service with an intake appointment to determine if they’re eligible both from a service and a financial need.

Eisenhauer said Dauphin County handles 250 intakes a month for mental health services; the Cumberland-Perry MHIDD program gets about 200 intakes a month, said Cumberland County Mental Health Administrator Silvia Herman.

“You can get in the front door and then there’s a wait,” Herman said.

Eisenhauer added, “We have access problems in the public mental health system. The waiting time to get to an outpatient clinic can be measured in months for some people.”

A shortage of psychiatrists

Part of the problem is a lack of psychiatrists.

“There’s a shortage nationwide. But demand itself is increasing,” noted Steve Bucciferro, director of Behavioral Health Services at Holy Spirit Hospital. The program provides crisis intervention services for Cumberland and Perry counties, as well as inpatient and outpatient services, and specialty services for seniors, women and teens.

“We have increased the number of psychiatrists and therapists,’’ he said. “Each time we do that, they get filled up right away.”

Bucciferro said the department logged 54,193 outpatient visits alone for the fiscal year ended June 2013.

“Typically the wait time to see a psychiatrist is longer than a psychologist or counselor due to available resources,” said Ruth Moore, director of business development at the Pennsylvania Psychiatric Institute.

“Individuals are encouraged to work closely with their counselor/psychologist during the wait period” for a psychiatrist’s appointment, Moore said. She said wait times are similar for patients regardless of whether they have insurance.

Lynn Keltz, executive director of the Pennsylvania Mental Health Consumers’ Association, said her group often recommends those seeking help should contact their primary care physician first and advises individuals that they may see a psychologist or licensed social worker without first seeing a psychiatrist.

But the community mental health system is more than just counseling and crisis care. It encompasses everything from community residential rehab services and supported living to peer-to-peer classes and supportive employment programs.

“What is critical about county-funded services is that they ... pay for a multitude of services that are not covered by any other resource,” Herman said. “Many of these services really promote recovery and support individuals in better understanding, managing and developing opportunities to be fully community-integrated.”

Concerns over further funding cuts

Dauphin County is one of a handful of counties that has been given flexibility in using the federal and state funds it receives to meet needs in various areas. While Hartwick appreciated the creativity it allows, he likened it to “trying to bail water out of an already half-afloat canoe.”

Keltz said it can be difficult to get people to focus on the needs of those with mental illness.

“There’s a lot of stigma about people who have mental illnesses and it makes it easier for legislators and policy makers to make cuts,” said Keltz. “It’s more than just money. It’s the attitude. People need to realize that at some point 25 percent of American experience psychological distress or a mental illness.”

Herman agreed.

“People with mental illness ... could be your daughter, son, spouse, best friend. This could be you tomorrow,” Herman said. “That’s stuff people don’t’ want to think about.”

One of the many findings, for instance, is that almost four out of five respondents, or 79 percent, said society tends to think of individuals with physical, mental or intellectual disabilities “with discomfort and awkwardness.”

That very attitude is targeted by the Stigma Project, a long-term effort underwritten by the Pennsylvania Developmental Disabilities Council, Keltz said. The project is designed to educate society “to look beyond the label.”

Holy Spirit promotes mental health as “part of a wellness program,” Bucciferro said. “General behavioral health – depression, anxiety – is more what a family doctor or minister might stress. We talk about it as part of regular health care.”

Eisenhauer agreed education is key.

“We don’t’ talk about what mental illness is as far as signs and symptoms,” he said. “People are delayed in seeking assistance because they don’t recognize what is going on with themselves and perhaps their support system doesn’t understand it either.”

Herman added that once people seek treatment, they need the support of their families and communities to fully recover.

“When individuals have a behavioral health challenge, folks become distant,” she said. “That’s totally contrary to what people need. The biggest thing that promotes their recovery is relationships, friendships and being part of a community.”